Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Despite advancement in pediatric cardiac surgery, yet post-operative CHB patients still present obviously, with patients referred for permanent pacing and starting long term morbidity necessitate lifelong follow up although the original cardiac anomaly itself mostly repaired totally. Objective: The aim of the study is to determine the incidence of early permanent postoperative CHB requiring pacemaker implantation following open surgical repair of congenital heart disease. Study design: Prospective descriptive study. Setting: Large two centers for congenital cardiac surgery in Egypt: Abo-Elreesh Cairo university hospital and Atfal {u2013}Misr hospital cardiothoracic center.Method: All Patients who developed CHB following cardiac surgery in period from February 2018 to February 2019 were included, detailed preoperative and operative and post-operative data were collected and statistically analyzed.Results: Post-operative early permanent CHB was diagnosed in 50/1668 (3%) post cardiac surgery. CHB patients were confined mainly to TOF (50%), VSD (28%), AVC (12%) and ASD (6%). Characteristic data of post-operative blocked patients showed:mechanical ventilation hours >6 hrs, pre and post-operative heart rate changes (P value <0.001), pre and post-operative cardiac function change (P value <0.001), IVC distensiblility index 16-18, ICU stay >3 days and hospital stay >7days.Conclusion: Permanent complete heart block incidence in two major congenital open cardiac surgery centers in Egypt is 3%. CHB usually follows repair of certain cardiac defects; TOF, VSD, AVC, ASD. CHB has a significant impact on morbidity involving Affection of cardiac function, ventilation hour, ICU stay and hospital stay

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